Wednesday, 26 August 2009

Idiotic WHO advice on the use of Tamilflu

Tamilflu is only effective within 48 hours on the onset of symptomswhich means fever or runny nose.

After 5 days patients may turn to the worst suddenly. On then shouldTamilflu be given, according to WHO. This makes Tamilflu ineffectiveand will create Tamilflu-resistant Swine Flu virus.

50% of patients admitted to hospitals have no underlying diseases, but75% of those who survived were previously healthy.So why give priority to patients who have underlying diseases whereTamilflu is not as effective?

Tamilflu is designed to save lives, not to waste it on people who donot benefit from it the most, i.e. those who are late and with seriousunderlying diseases. As long as there is stock of Tamilflu, it shouldbe given to all those where lives need to be saved and have thegreatest chance of making full use of it.

Using Tamilflu for cases that are already more than 5 days is justridiculous and a waste of resources. It is similar to vaccinating oldpeople that only have effectiveness of less than 10%.

The World Health Organization is warning that underlying healthproblems "will not reliably predict all or even most cases" of severeH1N1 influenza.

Worldwide, around 40 per cent of severe cases are now occurring inpreviously healthy children and adults, usually under the age of 50,WHO said Friday in issuing new guidelines on the use of antiviralsdeveloped by an international expert panel.

In Canada, among cases where information is available, about 46 percent of those hospitalized so far with human swine flu had nounderlying medical condition. Among those who have died, 75 per centhad a pre-existing health problem, according to the Public HealthAgency of Canada.

Most patients infected with the pandemic virus have mild symptoms andrecover fully within a week, even without any medical treatment, WHOsays.

But patients with severe H1N1 infection can experience "a sudden andvery rapid deterioration in their clinical condition", WHO said,usually on Day 5 or 6 after the onset of symptoms. H1N1 can causeviral pneumonia, which destroys lung tissue and is a leading cause ofdeath for H1N1 and seasonal flu, and multi-organ failure, includingfailure of the heart, kidneys and liver.

"Clinicians, patients and those providing home-based care need to bealert to warning signals that indicate progression to a more severeform of illness, and take urgent action, which should includetreatment with oseltamivir," or Tamiflu, the world health agency says.

Serious cases should be treated immediately, ideally within 48 hoursof the beginning of symptoms, but treatment should be provided, evenif started later.

The recommendation applies to all patients, including pregnant women,and all age groups, including young children and infants.

In children under age 1, recent Canadian data show higher rates ofhospitalizations, admissions to intensive-care units and death,compared with all H1N1 cases in Canada.

WHO says anyone with an underlying medical condition should also getTamiflu as soon as possible, without waiting for lab test results, anddoctors should consider using higher doses than normal in severecases.

But healthy people with mild or "uncomplicated illness" don't need thedrug, the agency says.

Neither do otherwise healthy children older than five, unless theirillness persists or worsens, WHO says.

As of Aug. 15, a total of 1,422 cases of people hospitalized withswine flu had been reported to the Public Health Agency of Canada.This week, four new deaths were reported, for a total of 71 deathssince the beginning of the pandemic.

Canada has a national antiviral stockpile of 55 million doses of bothTamiflu and Relenza, another flu drug. The Public Health Agency ofCanada has recommended the drugs be reserved for those at high risk ofcomplications of the flu, and for people with more severe illness, andnot people who are only mildly sick.

If Tamiflu is overused, the H1N1 virus could adapt and developresistance.

Since the start of the outbreak, the official messaging has beenpeople with underlying health problems, such as asthma, diabetes andheart disease, are among the most vulnerable to getting severely sickwith H1N1.

"That is still one of the groups that we need to identify, and that'swhat we're doing — identifying new students on campus who have thoseproblems," says Dr. Pierre-Paul Tellier, director of student healthservices at McGill University in Montreal.

But the warning that 40 per cent of cases are occurring in otherwisehealthy people "also then tells us that we need to maybe be a littlebit more vigilant at looking for other individuals who may bedeteriorating a little more rapidly," he says. "It does indicate thereis a change."

The Public Health Agency of Canada's national microbiology laboratoryin Winnipeg is working with intensive-care units across Canada toinvestigate why severe infections are occurring in certain people.More than 100 cases are under review.